Discovery Health
CLAIM DISPUTE

I would like to express how disappointed i am with the service i have thus received from Discovery KeyCare. I have permission to deal with my dads medical aid.
My Dad is a member on the Keycare plan and was admitted on the 5 February 2013. When he was referred for admission it was related to a cardiac problem, my dad has a 12 mnth waiting [period for any URTD AND IS FULLY AWARE OF THIS.When authorisation was requested by the hospital from Discovery it was granted by Mrs M Retief for 24 hours. It was never mentioned that this auth can be revoked. My dad was admitted from the 5-9 February 2013. Claims are now rejected by the medical aid as Discovery claims authorisation was never given due to the waiting period. If this was True how was my dad admitted? my argument is if the members progress and treatment were updated daily by a hospital CaseManager and this was communicated to Discovery, wouldn't this issue have been picked up earlier and have prevented the member from having unpaid bills. DISCOVERY PLEASE ASSIST, AS MY DAD DOES NOT NEED THIS STRESS, I HAVE RESORTED TO THE MEDIA AS I RECEIVED NO JOY FROM YOUR CALL CENTRE OR THE WALK IN CENTRE (SANTON).

Company: Discovery Health
Country: South Africa
City: SANDTON

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